| NPI | 1760647366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS015283) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: PA OSO15283) |
| 208M00000X Hospitalist (Licence: PA OS015283) | |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2018-04-10 |