| NPI | 1356505192 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IN 01070121A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2015-0901) |
| 171000000X Military Health Care Provider | |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2024-02-15 |