| NPI | 1265960074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD474655) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD474655) |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2021-07-09 |