| NPI | 1376074666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 85702) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 85702) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2020-07-22 |