| NPI | 1104077312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: WV 30789) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2014027663) |
| 207R00000X Internal Medicine (Licence: IN 01069485A) | |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2022-02-11 |