| NPI | 1164877296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN976) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PR 19586) |
| 207R00000X Internal Medicine (Licence: FL ACN976) | |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2024-05-16 |