| NPI | 1619463130 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 009089) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 58.030211) |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2022-08-05 |