| NPI | 1639739519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SD 13557) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R-11665) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2023-06-29 |