| NPI | 1912243528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101254297) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 46274) |
| Enumeration Date | 2012-12-31 |
| Last Update Date | 2022-02-17 |