| NPI | 1619537784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IN 02006864A) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 7179) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2022-10-11 |