| NPI | 1023543394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NV DO2739) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV DO2739) |
| 207R00000X Internal Medicine (Licence: MI 5151009981) | |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2020-08-21 |