| NPI | 1134649270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 86101) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2019007766) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2022-01-20 |