| NPI | 1134502115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MS 26055) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN22002) |
| 207R00000X Internal Medicine (Licence: MS 26055) | |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2019-02-22 |