| NPI | 1376047886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2024039714) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 30606) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2024-10-21 |