| NPI | 1457037988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD494279) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT228052) |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2026-03-09 |