| NPI | 1811975469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2009-01147) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 297471) |
| 207R00000X Internal Medicine (Licence: MO R8N75) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2023-07-10 |