| NPI | 1386902062 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 26534) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 63153) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2024-05-17 |