| NPI | 1598140105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 82020) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101264262) |
| 208M00000X Hospitalist (Licence: CT 61923) | |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2024-01-04 |