| NPI | 1821082157 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 91627) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD452991) | 
| Enumeration Date | 2005-09-01 | 
| Last Update Date | 2024-05-03 |