| NPI | 1700448826 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ND 15814) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: SD 0593) |
| Enumeration Date | 2019-06-29 |
| Last Update Date | 2022-02-11 |