| NPI | 1790016541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 64164) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 64164) |
| 207R00000X Internal Medicine (Licence: CA a112413) | |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2020-01-10 |