| NPI | 1154617785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OS016927) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS016927) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2017-02-08 |