| NPI | 1174961361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 9725798-1204) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV SL0963) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2022-07-21 |