| NPI | 1053672048 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 75157) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101020049) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2021-11-18 |