| NPI | 1164452090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60153779) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD427974) |
| 208M00000X Hospitalist (Licence: PA MD427974) | |
| 207R00000X Internal Medicine (Licence: WA MD60153779) | |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2015-09-24 |