| NPI | 1093080418 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101258646) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 28998) |
| 208M00000X Hospitalist (Licence: VA 0101258646) | |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2019-06-27 |