| NPI | 1508395658 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MD H91393)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD H91393)  | 
| 207R00000X Internal Medicine (Licence: MD H0091393)  | |
| Enumeration Date | 2017-06-11 | 
| Last Update Date | 2021-07-26 |