| NPI | 1750355921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC AL32157) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD029468) |
| 207R00000X Internal Medicine (Licence: SC AL32157) | |
| 207R00000X Internal Medicine (Licence: PA MD029468E) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2020-10-20 |