| NPI | 1003379884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX T5283) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ND 19777) |
| 208M00000X Hospitalist (Licence: ME DO3873) | |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2024-05-29 |