| NPI | 1134501133 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NH 20599) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 274958) | 
| Enumeration Date | 2015-06-25 | 
| Last Update Date | 2020-06-08 |