| NPI | 1407107790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MT203020) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.130161) |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2018-01-10 |