| NPI | 1902172828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 322450) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME137678) |
| 208M00000X Hospitalist (Licence: CT 56170) | |
| 208M00000X Hospitalist (Licence: NH 17232) | |
| Enumeration Date | 2012-03-25 |
| Last Update Date | 2020-07-28 |