| NPI | 1316428998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2021030449) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT215360) |
| 207R00000X Internal Medicine (Licence: MO 2021030449) | |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2022-09-02 |