| NPI | 1194017178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD194446) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD194446) |
| 2083A0100X Preventive Medicine Aerospace Medicine (Licence: CA A122446) | |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2020-08-12 |