| NPI | 1134509359 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101262749) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0116028024) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2022-03-10 |