| NPI | 1568628063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SD 7777) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 7777) |
| 207R00000X Internal Medicine (Licence: MN 55867) | |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2022-03-29 |