| NPI | 1972698611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD445166) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101249084) |
| 207R00000X Internal Medicine (Licence: MD D0062006) | |
| 207R00000X Internal Medicine (Licence: PA MD445166) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2018-03-17 |