| NPI | 1154579696 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2012-02011) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 51698) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2020-12-01 |