| NPI | 1407186422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2012-00019) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2012-00019) |
| 207R00000X Internal Medicine (Licence: MI 4301089020) | |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2022-12-01 |