| NPI | 1205190899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 73201) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 73201) |
| 207R00000X Internal Medicine (Licence: AL MD.35140) | |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2020-05-22 |