| NPI | 1619544293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ND 20259) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ND RL17448) |
| Enumeration Date | 2021-06-10 |
| Last Update Date | 2024-01-25 |