| NPI | 1245316504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD422000) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD422000) |
| Enumeration Date | 2006-10-30 |
| Last Update Date | 2021-02-09 |