| NPI | 1730423997 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 89441) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 89441) |
| 208M00000X Hospitalist (Licence: WI 67525-21) | |
| Enumeration Date | 2012-11-12 |
| Last Update Date | 2023-09-08 |