| NPI | 1861755365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NH 18938) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 18938) |
| 207Q00000X Family Medicine (Licence: PA MD453668) | |
| 208M00000X Hospitalist (Licence: PA MD453668) | |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2018-08-28 |