| NPI | 1710268115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA DO-04545) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV ED0227A) |
| 207R00000X Internal Medicine (Licence: IA DO-04545) | |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2017-11-09 |