| NPI | 1104311604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 5101024308) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MT 92744) |
| 207R00000X Internal Medicine (Licence: MT 92744) | |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2021-04-29 |