| NPI | 1902197080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 13193) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND 13193) |
| 207R00000X Internal Medicine (Licence: NC 173109) | |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2022-03-25 |