| NPI | 1235622093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2021-01596) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072830) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2021-07-09 |