| NPI | 1225404650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 20170249889) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 20170249889) |
| 208M00000X Hospitalist (Licence: NY 297527) | |
| 208M00000X Hospitalist (Licence: WV 28289) | |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2024-05-30 |