| NPI | 1932495835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 260971) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT198812) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2025-01-22 |