| NPI | 1093121527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 66932) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 66932-20) |
| 207R00000X Internal Medicine (Licence: IL 125.064392) | |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2021-11-18 |