| NPI | 1609129634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 62237) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 62237) |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2017-11-14 |