| NPI | 1720055817 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 45824) | 
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WI 45824020) | 
| 208M00000X Hospitalist (Licence: WI 45824020) | |
| Enumeration Date | 2006-03-07 | 
| Last Update Date | 2021-11-24 |