| NPI | 1710564174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2024-01297) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.077430) |
| 207R00000X Internal Medicine (Licence: NC 2024-01297) | |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2024-07-02 |