| NPI | 1043690795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CT 66547) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 264410) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2020-09-11 |