| NPI | 1619246568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 87961) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME112618) |
| 207R00000X Internal Medicine (Licence: GA 87961) | |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2021-07-21 |