| NPI | 1508841032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2003-00332) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101251249) |
| 207R00000X Internal Medicine (Licence: TN 38537) | |
| 208M00000X Hospitalist (Licence: TN 38537) | |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2022-07-21 |