| NPI | 1902165475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA 311982) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 24092) |
| 207R00000X Internal Medicine (Licence: AL 33188) | |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2022-07-21 |