| NPI | 1164760484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2023-00360) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2023-00360) |
| Enumeration Date | 2013-01-21 |
| Last Update Date | 2023-11-16 |