| NPI | 1912929423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TX N6427) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A71260) |
| 208M00000X Hospitalist (Licence: KY 48721) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2021-07-30 |