| NPI | 1790045086 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2016-01179) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 20-37944) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2021-06-14 |