| NPI | 1669907242 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA MD-48097)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD477147)  | 
| 207R00000X Internal Medicine (Licence: IA MD-48097)  | |
| 207R00000X Internal Medicine (Licence: MO 2020019628)  | |
| 207R00000X Internal Medicine (Licence: PA MD477147)  | |
| 207R00000X Internal Medicine (Licence: CA A193655)  | |
| Enumeration Date | 2017-04-20 | 
| Last Update Date | 2024-04-18 |