| NPI | 1912492240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY 54864) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301114595) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2021-06-11 |