| NPI | 1871085019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA DO-08516) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-11272) |
| 207R00000X Internal Medicine (Licence: IA DO-08516) | |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2021-11-09 |