| NPI | 1407241110 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2018-02057) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 294833) |
| 207R00000X Internal Medicine (Licence: FL ME133942) | |
| 207R00000X Internal Medicine (Licence: NC 241942) | |
| Enumeration Date | 2015-03-31 |
| Last Update Date | 2023-03-02 |