| NPI | 1083001374 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MT MED-PHYS-LIC-68034) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 6021) |
| 207R00000X Internal Medicine (Licence: WI 67350) | |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2022-02-23 |