| NPI | 1184855421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 83434) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116021815) |
| 207R00000X Internal Medicine (Licence: SC 83434) | |
| 207R00000X Internal Medicine (Licence: KY 03443) | |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2021-07-13 |