| NPI | 1356638076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0102203297) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0102203297) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2024-03-14 |