| NPI | 1114214004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 62482) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 62482) |
| 207R00000X Internal Medicine (Licence: MI 5101019580) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2021-05-20 |