| NPI | 1306073028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 69757) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 22199) |
| 207R00000X Internal Medicine (Licence: GA 069757) | |
| Enumeration Date | 2009-06-20 |
| Last Update Date | 2019-12-04 |