| NPI | 1508128885 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 073668) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL1582) |
| Enumeration Date | 2012-06-12 |
| Last Update Date | 2020-10-13 |