| NPI | 1205397171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS020815) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA OS020815) |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2022-07-12 |