| NPI | 1821511965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2020021391) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT017804) |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2020-12-10 |