| NPI | 1376987297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2016012441) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2016012441) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2022-03-01 |