| NPI | 1144480997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01069492D) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME109745) |
| 207R00000X Internal Medicine (Licence: GA 074303) | |
| 208M00000X Hospitalist (Licence: MN 67370) | |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2020-05-13 |