| NPI | 1770840183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD455235) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 28221) |
| Enumeration Date | 2012-04-23 |
| Last Update Date | 2018-10-26 |