| NPI | 1902302698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT 111717) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35.138066) |
| 208M00000X Hospitalist (Licence: MT 111717) | |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2023-10-06 |