| NPI | 1396922415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS13112) |
| Additional Taxonomies | 104100000X Social Worker |
| 207R00000X Internal Medicine (Licence: FL None) | |
| 207R00000X Internal Medicine (Licence: FL OS13112) | |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2021-01-06 |