NPI | 1558707562 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 58092) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 58092) |
207R00000X Internal Medicine (Licence: PA MD458911) | |
Enumeration Date | 2013-05-16 |
Last Update Date | 2020-10-08 |