| NPI | 1184114175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 63278) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1726) |
| 208M00000X Hospitalist (Licence: VA 0101272131) | |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2022-09-28 |