| NPI | 1174920961 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS14560) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO4029) |
| Enumeration Date | 2014-11-23 |
| Last Update Date | 2022-10-03 |