| NPI | 1124452701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101262565) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 29464R) |
| Enumeration Date | 2013-08-30 |
| Last Update Date | 2019-08-14 |