| NPI | 1700415965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 5101027068) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101027068) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2023-06-29 |