| NPI | 1679993711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 4365) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102204943) |
| 208M00000X Hospitalist (Licence: TN 4365) | |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2021-10-01 |