| NPI | 1568430817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101255048) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101255048) |
| 207R00000X Internal Medicine (Licence: PA MD061649L) | |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2021-07-02 |