| NPI | 1790031763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 073944) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT201041) |
| 207R00000X Internal Medicine (Licence: GA 073944) | |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2021-01-08 |