| NPI | 1912360918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 17165) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A17165) |
| 208M00000X Hospitalist (Licence: CA 20A17165) | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2022-03-04 |