| NPI | 1366705741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101273698) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX S4199) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2022-08-11 |