| NPI | 1881894400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301097159) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MN 57343) |
| 208M00000X Hospitalist (Licence: MI 4301097159) | |
| Enumeration Date | 2007-07-21 |
| Last Update Date | 2022-10-11 |