| NPI | 1912210915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD449448) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT196342) |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2020-08-13 |