| NPI | 1295265163 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OS022035) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL41043) |
| 207Q00000X Family Medicine (Licence: NY 302758) | |
| 207Q00000X Family Medicine (Licence: PA OS022035) | |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2024-06-28 |