| NPI | 1700316528 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2020019634) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2020019634) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2024-01-09 |