| NPI | 1982610663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS-009147-L) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PA OS009147L) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2017-06-28 |