| NPI | 1912927161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 074862) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 242672) |
| 207R00000X Internal Medicine (Licence: VA 0101236201) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2019-10-02 |