| NPI | 1770747511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AL 31163) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 31163) |
| 207R00000X Internal Medicine (Licence: MI 4301091998) | |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2020-12-01 |