| NPI | 1548556053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 69890) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI 19068) |
| 207R00000X Internal Medicine (Licence: CA A132011) | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2019-04-18 |