| NPI | 1235417825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 71962) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 5057) |
| Enumeration Date | 2011-07-30 |
| Last Update Date | 2020-01-08 |