| NPI | 1164981007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 74852) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 74852-20) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2022-11-16 |