| NPI | 1255383428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2006-00313) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 32239) |
| 207R00000X Internal Medicine (Licence: NC 200600313) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2020-12-15 |