| NPI | 1548792708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 84944) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 84944) |
| 207R00000X Internal Medicine (Licence: PA MT216202) | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2021-05-11 |