| NPI | 1740632843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD468301) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD468301) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2026-04-02 |