| NPI | 1356780043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2020-00473) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 191452) |
| 207R00000X Internal Medicine (Licence: VA 0101259279) | |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2020-11-18 |