| NPI | 1710445689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: HI DOS2436) |
| Additional Taxonomies | 208D00000X General Practice (Licence: HI DOS-2436) |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2024-07-25 |