| NPI | 1780972406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 64890) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 64890) |
| Enumeration Date | 2011-07-14 |
| Last Update Date | 2021-12-01 |