| NPI | 1073957429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR DO182011) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO4790) |
| Enumeration Date | 2013-04-28 |
| Last Update Date | 2023-07-21 |