| NPI | 1083033310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01084209A) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WV 27625) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2022-11-15 |