| NPI | 1316960149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OS007163L) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND 8371) |
| 207R00000X Internal Medicine (Licence: NC 2008-01979) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-01-16 |