| NPI | 1619102449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 52997) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 52997-020) |
| Enumeration Date | 2009-05-22 |
| Last Update Date | 2021-12-01 |