| NPI | 1720308661 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID M-12156) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ID M12156) | 
| Enumeration Date | 2010-06-02 | 
| Last Update Date | 2019-07-10 |