| NPI | 1932689528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WV 0101268554) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101268554) |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2023-02-01 |