| NPI | 1720191760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA DO-03312) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 3312) |
| 208100000X Physical Medicine & Rehabilitation (Licence: IA DO-03312) | |
| 207R00000X Internal Medicine (Licence: IA DO-03312) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2018-12-11 |