| NPI | 1790170181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 60166) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 60166) |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2018-07-09 |