| NPI | 1649704495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 5101025579) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI G521974636123) |
| 207R00000X Internal Medicine (Licence: MI 5101025579) | |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2022-04-23 |