| NPI | 1740244219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD042157E) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD042157E) |
| 207QS0010X Family Medicine, Sports Medicine (Licence: PA MD042157E) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2024-04-17 |