| NPI | 1659821601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD469152) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD469152) |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2019-10-31 |