| NPI | 1679917702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2019-01420) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2019-01420) |
| 208M00000X Hospitalist (Licence: OR MD177089) | |
| 207R00000X Internal Medicine (Licence: KY R3198) | |
| Enumeration Date | 2013-04-19 |
| Last Update Date | 2020-10-26 |