| NPI | 1376650010 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2015-01445) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN MD0000039260) |
| 207R00000X Internal Medicine (Licence: IN 01049606A) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-10-28 |