| NPI | 1700184157 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: KY TP396)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB09456900)  | 
| Enumeration Date | 2011-03-09 | 
| Last Update Date | 2024-11-11 |