| NPI | 1669736559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 73154) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 73154) |
| 208M00000X Hospitalist (Licence: GA 73154) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2020-09-02 |