| NPI | 1942202122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101013775) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301013775) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2021-01-07 |