| NPI | 1932377884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD450505) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 36231) |
| 207Q00000X Family Medicine (Licence: NM MD 2012-0007) | |
| 207Q00000X Family Medicine (Licence: TX BP10033420) | |
| 207Q00000X Family Medicine (Licence: PA md450505) | |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2020-02-20 |