| NPI | 1972896025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA MD449182) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT199728) |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2019-05-01 |