| NPI | 1568993236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 66366) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 66366) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2020-10-23 |