| NPI | 1700170552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101256137) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101256137) |
| 208M00000X Hospitalist (Licence: MD D77080) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2023-10-27 |