| NPI | 1679093355 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A173837) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2017020347) |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2021-10-06 |