| NPI | 1609864446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 38161) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 9400694) |
| 208M00000X Hospitalist (Licence: NC 9400694) | |
| 208M00000X Hospitalist (Licence: SC 20751) | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2021-07-14 |