| NPI | 1912907593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101262334) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0061783 ) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2022-05-20 |