| NPI | 1255726543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 4301501808) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301501808) |
| 207R00000X Internal Medicine (Licence: PA MD464278) | |
| 208M00000X Hospitalist (Licence: PA MD464278) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2020-06-10 |