| NPI | 1245210392 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT 42849) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MT 42849) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2024-04-25 |