| NPI | 1407152366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MN 65482) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IN 01081207) |
| 207R00000X Internal Medicine (Licence: IL 036.144356) | |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2021-11-17 |