| NPI | 1972591402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA MD-34118) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 34118) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2018-03-15 |