| NPI | 1366002966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 77206-21) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-11579) |
| 207R00000X Internal Medicine (Licence: WI 77206-21) | |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2024-08-22 |