| NPI | 1548260383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: RI 6792) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: RI MD06792) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2021-01-04 |