| NPI | 1609257757 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 056940) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CT 56940) |
| 208M00000X Hospitalist (Licence: CT 056940) | |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2020-10-22 |