| NPI | 1700171618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 33754) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC LL33754) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2021-06-30 |