| NPI | 1750677274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD453330) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT199829) |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2015-01-27 |