| NPI | 1740497684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WA MD60225872) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT185108) |
| 208M00000X Hospitalist (Licence: PA MD432434) | |
| 207Q00000X Family Medicine (Licence: WA MD60225872) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2015-12-08 |