| NPI | 1578794780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2012-01349) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301094282) |
| 207R00000X Internal Medicine (Licence: VA 0101251495) | |
| 208M00000X Hospitalist (Licence: SC 35631) | |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2021-08-31 |