| NPI | 1255656211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD463592) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 2901101) |
| 207R00000X Internal Medicine (Licence: PA MD463592) | |
| Enumeration Date | 2010-04-02 |
| Last Update Date | 2020-12-02 |