| NPI | 1992362396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA DO-06031) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OT019094) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2022-08-03 |