| NPI | 1588075626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WV 28706) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125064376) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2019-02-19 |