| NPI | 1255726303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 60915) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 13179705) |
| Enumeration Date | 2015-04-04 |
| Last Update Date | 2018-07-16 |