| NPI | 1952718884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101264421) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 59322) |
| 207R00000X Internal Medicine (Licence: VA 0101264421) | |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2021-07-30 |