| NPI | 1154358075 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD19387) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD19387) |
| 207R00000X Internal Medicine (Licence: OR MD19387) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2021-01-04 |