| NPI | 1861788952 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 38619) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 38619) |
| 207R00000X Internal Medicine (Licence: NC 2014-01535) | |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2021-06-11 |