| NPI | 1972957504 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 69010-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 69010) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2021-01-20 |