| NPI | 1003282427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102205336) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 62046) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2019-10-02 |