| NPI | 1043643687 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA DO-04484) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 4484) |
| 207R00000X Internal Medicine (Licence: NE 1043) | |
| 208M00000X Hospitalist (Licence: NE 1043) | |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2019-12-18 |