| NPI | 1083866651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 22127) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MS 22127) |
| 208M00000X Hospitalist (Licence: TN 2030) | |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2019-07-11 |