| NPI | 1023364593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD171518) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD171518) |
| 207R00000X Internal Medicine (Licence: MI 4301100692) | |
| 207R00000X Internal Medicine (Licence: NV 18113) | |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2019-09-13 |