| NPI | 1639257892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD019420E) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: PA MD019420E) |
| 208D00000X General Practice (Licence: PA MD019420E) | |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2018-02-20 |