| NPI | 1962934844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 81165) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 81165) |
| 207R00000X Internal Medicine (Licence: IA DO-05284) | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2023-08-11 |