| NPI | 1720461932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL OS14279) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 02006019A) |
| 207R00000X Internal Medicine (Licence: FL UO4459) | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2020-06-03 |