| NPI | 1376526418 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2005005178)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2005005178)  | 
| Enumeration Date | 2005-11-22 | 
| Last Update Date | 2021-03-12 |