| NPI | 1205140282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 36758) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT197990) |
| 208M00000X Hospitalist (Licence: OH 35.126486) | |
| 208M00000X Hospitalist (Licence: PA MD449019) | |
| Enumeration Date | 2010-08-02 |
| Last Update Date | 2026-08-06 |