| NPI | 1356467260 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD447315) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD447315) |
| 207Q00000X Family Medicine (Licence: DE C1-0008791) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2017-05-11 |