| NPI | 1962543496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 29654) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: UT 11253504-1205) |
| 208M00000X Hospitalist (Licence: ID M-13495) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-03-30 |