| NPI | 1861928319 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS19012) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT017750) |
| 208M00000X Hospitalist (Licence: PA OT017750) | |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2023-01-18 |