| NPI | 1124550215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101027072) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 3644) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2022-11-04 |