| NPI | 1134534050 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL NE153189) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME153189) |
| 207R00000X Internal Medicine (Licence: KS 94-08711) | |
| 208M00000X Hospitalist (Licence: WI 82277) | |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2024-02-23 |