| NPI | 1013919380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 4301102218) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 026319) |
| 207R00000X Internal Medicine (Licence: MI 4301102218) | |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2021-07-29 |