| NPI | 1215168794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 45850) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT194151) |
| 207R00000X Internal Medicine (Licence: AZ 45850) | |
| Enumeration Date | 2009-08-02 |
| Last Update Date | 2015-10-06 |