| NPI | 1558608695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD449314) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD449314) |
| 208M00000X Hospitalist (Licence: MA 261029) | |
| 207R00000X Internal Medicine (Licence: MA 260129) | |
| Enumeration Date | 2013-01-09 |
| Last Update Date | 2021-02-09 |