| NPI | 1669817169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AL 38403) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 54822) |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2019-08-06 |