| NPI | 1508210204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA 323356) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 323356) |
| 207R00000X Internal Medicine (Licence: AL 38275) | |
| 208M00000X Hospitalist (Licence: AL 38275) | |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2020-07-21 |