| NPI | 1619307139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 3182) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO 3728) |
| Enumeration Date | 2013-11-19 |
| Last Update Date | 2018-06-01 |