| NPI | 1831175942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 12686) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 1249) |
| 207R00000X Internal Medicine (Licence: OH 34.012490) | |
| 208M00000X Hospitalist (Licence: NV 1249) | |
| 208M00000X Hospitalist (Licence: CA 12686) | |
| 208M00000X Hospitalist (Licence: ID O-0638) | |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2020-12-01 |