| NPI | 1962715425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101260450) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.058686) |
| 207R00000X Internal Medicine (Licence: MA 294448) | |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2022-12-15 |