| NPI | 1679003321 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OS020323) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 83567) |
| 207R00000X Internal Medicine (Licence: PA OS020323) | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2026-01-26 |