| NPI | 1619281300 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301097356) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OH 35137316) |
| Enumeration Date | 2010-08-05 |
| Last Update Date | 2020-12-14 |