| NPI | 1750745410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OT016917) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT016917) |
| 207R00000X Internal Medicine (Licence: PA OS018989) | |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2022-04-20 |