| NPI | 1003445263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 4301505692) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301505692) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2023-06-30 |