| NPI | 1720392012 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD440840) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD440840) |
| 281P00000X Chronic Disease Hospital (Licence: PA MD440840) | |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2019-02-26 |