| NPI | 1063717239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101249750) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101249750) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2022-07-08 |