| NPI | 1437413721 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301101224)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IN 01076112A)  | 
| 261QU0200X Clinic/Center, Urgent Care (Licence: MI 802446128)  | |
| 207R00000X Internal Medicine (Licence: IN 01076112A)  | |
| Enumeration Date | 2012-07-02 | 
| Last Update Date | 2024-05-17 |