| NPI | 1780684332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OS014943) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101010451) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2024-09-12 |