| NPI | 1922488808 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2022010401)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 57776)  | 
| Enumeration Date | 2015-06-04 | 
| Last Update Date | 2022-07-25 |