| NPI | 1649624602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102205569) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MD H87106) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2019-10-23 |