| NPI | 1174059000 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD477385)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT212817)  | 
| 207R00000X Internal Medicine (Licence: PA MD477385)  | |
| 208M00000X Hospitalist (Licence: OH 35.139223)  | |
| Enumeration Date | 2017-05-11 | 
| Last Update Date | 2025-01-10 |