| NPI | 1942864913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 66605) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 66605) |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2022-07-25 |