| NPI | 1609871490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS009226L) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: PA os-009226-l) |
| 208M00000X Hospitalist (Licence: PA OS009226L) | |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2020-12-19 |