| NPI | 1780147710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 92926) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME148608) |
| 207R00000X Internal Medicine (Licence: FL TRN29328) | |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2024-01-16 |