| NPI | 1457320970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 69542) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 69542) |
| 207R00000X Internal Medicine (Licence: NC 200100893) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2023-06-19 |