| NPI | 1114598679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2024022167) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 9027) |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2024-07-18 |