| NPI | 1962842104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2014041288) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2014041288) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2021-06-02 |