| NPI | 1437404761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2011018182) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 03680) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2020-02-06 |