| NPI | 1174942015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME141151) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A140011) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2024-07-16 |