| NPI | 1184159139 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD474972) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 305942) |
| Enumeration Date | 2017-04-27 |
| Last Update Date | 2023-10-18 |