| NPI | 1912360561 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MD D88142) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D88142) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2019-09-09 |