| NPI | 1356015507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2024-01355) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI LP05471) |
| Enumeration Date | 2021-08-02 |
| Last Update Date | 2024-08-23 |