| NPI | 1740849777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OT019407) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA OS020814) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2025-01-17 |