| NPI | 1194111757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2018-01391) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2018-01391) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2023-05-23 |