| NPI | 1760738678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 13620) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND 13620) |
| 207R00000X Internal Medicine (Licence: NE 6866) | |
| Enumeration Date | 2012-07-28 |
| Last Update Date | 2021-10-13 |