| NPI | 1720512072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 86465) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 86465) |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2024-01-06 |