| NPI | 1225422405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 77703) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 77703) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2024-07-31 |