| NPI | 1285625053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MT 48306) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 23985) |
| 207R00000X Internal Medicine (Licence: WY 7813A) | |
| 207RC0200X Internal Medicine Critical Care Medicine (Licence: WY 7813A) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2022-07-21 |