| NPI | 1518354489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101270660) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 62079) |
| Enumeration Date | 2015-04-18 |
| Last Update Date | 2020-10-12 |