| NPI | 1801193529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 38636) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 46525) |
| 207R00000X Internal Medicine (Licence: SC 38636) | |
| Enumeration Date | 2011-02-15 |
| Last Update Date | 2020-11-10 |