| NPI | 1710620331 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OS025178) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT021502) |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2025-09-08 |