| NPI | 1790104024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 40250) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 96867) |
| 208M00000X Hospitalist (Licence: GA 96867) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2024-03-26 |