| NPI | 1700376977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD474460) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD4744) |
| 207Q00000X Family Medicine (Licence: MD D0089272) | |
| Enumeration Date | 2018-05-14 |
| Last Update Date | 2024-09-18 |