| NPI | 1366861619 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0102204858) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102204858) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2018-01-23 |