| NPI | 1861912297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 75123) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 75123) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2023-03-15 |