| NPI | 1962485599 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO 21642) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101-053016) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2021-03-22 |