| NPI | 1700219003 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO 54604) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 54604) | 
| Enumeration Date | 2013-08-10 | 
| Last Update Date | 2024-06-14 |