| NPI | 1629023635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2018-01608) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IL 036114777) |
| 207R00000X Internal Medicine (Licence: IL 036114777) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2019-09-23 |