| NPI | 1790981868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD469555) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ME 018509) |
| 208M00000X Hospitalist (Licence: VA 0101262472) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2022-03-09 |