| NPI | 1295911139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL OS14007) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 2434) |
| 207R00000X Internal Medicine (Licence: PA OT 011752) | |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2018-04-16 |