| NPI | 1801180005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35.136398) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD450752) |
| 208M00000X Hospitalist (Licence: PA MD450752) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2021-01-04 |