| NPI | 1134623689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 101261) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-154230) |
| 207R00000X Internal Medicine (Licence: IL 125072540) | |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2024-09-16 |