| NPI | 1912177882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2011011829) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T9012) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2025-01-09 |