| NPI | 1871988774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MT MED-PHYS-LIC-66296) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MT MED-PHYS-LIC-66296) |
| 207R00000X Internal Medicine (Licence: MT MED-RES-LIC-42277) | |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2025-02-04 |