| NPI | 1922448018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 21653-875) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125064028) |
| 208M00000X Hospitalist (Licence: IL 036140741) | |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2022-10-07 |