| NPI | 1669836854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WY 11733A) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WY TL4356) |
| 208M00000X Hospitalist (Licence: WY 11733A) | |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2022-11-04 |