| NPI | 1326276619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MT195823) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MD D80306) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2017-09-20 |