| NPI | 1720230071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 26623) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 107897) |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2021-05-04 |