| NPI | 1306378864 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD61042100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 20086) |
| 208M00000X Hospitalist (Licence: NV 20086) | |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2023-01-23 |