| NPI | 1245543222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD184787) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT 197206) |
| 207R00000X Internal Medicine (Licence: TX P5656) | |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2023-07-25 |