| NPI | 1639136872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD449631) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD449631) |
| 208000000X Pediatrics (Licence: PA MD449631) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2015-03-20 |