| NPI | 1124503198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MD D0099853) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0099853) |
| 363AM0700X Physician Assistant, Medical (Licence: MD C06972) | |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2024-10-09 |