| NPI | 1588077093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 40645) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN# 19862) |
| 207R00000X Internal Medicine (Licence: SC 40645) | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2018-03-17 |