| NPI | 1679130611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 96151) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 96151) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2023-08-08 |