| NPI | 1700308699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 148425) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ND PT19280) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2023-01-16 |