| NPI | 1902224728 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: DC DO034876) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 51238) |
| 207R00000X Internal Medicine (Licence: IL 125.065793) | |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2022-07-21 |