| NPI | 1417306705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD468324) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT211793) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2019-08-01 |