| NPI | 1700235256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 39653) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL39653) |
| 207R00000X Internal Medicine (Licence: SC MD39653) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC MD39653) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC LL39653) | |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2021-09-20 |