| NPI | 1790749042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 5101007035) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101007035) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2022-04-22 |