| NPI | 1760469084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2017038349) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 40147) |
| 208M00000X Hospitalist (Licence: VA 0101254975) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2021-07-06 |