| NPI | 1811382922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD208982) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OR MD208982) |
| 208M00000X Hospitalist (Licence: MT MED-PHY-LIC-64155) | |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2023-02-10 |