| NPI | 1124683495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2022025499) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2022025499) |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2024-05-08 |