| NPI | 1356622393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2011-01240) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2011-01240) |
| Enumeration Date | 2011-09-05 |
| Last Update Date | 2021-01-22 |