| NPI | 1093792673 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD16770) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD16770) | 
| Enumeration Date | 2005-12-27 | 
| Last Update Date | 2023-08-25 |