| NPI | 1659710580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD464154) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MO 2015012494) |
| 208M00000X Hospitalist (Licence: MO 2015012494) | |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2021-09-30 |