| NPI | 1881946630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS14188) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL OS14188) |
| 207R00000X Internal Medicine (Licence: TN 2943) | |
| 207R00000X Internal Medicine (Licence: VA 0102203661) | |
| 208M00000X Hospitalist (Licence: TN 2943) | |
| 208M00000X Hospitalist (Licence: VA 0102203661) | |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2021-02-19 |