| NPI | 1972564763 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD419075)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA MD419075)  | 
| Enumeration Date | 2006-03-31 | 
| Last Update Date | 2025-10-14 |