| NPI | 1578501219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 35850) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 37819) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2023-09-13 |