| NPI | 1588855795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD432186) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD432186) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2023-03-07 |