| NPI | 1174793335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101243650) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101243650) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: VA 0101243650) | |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2025-01-02 |