| NPI | 1730476896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 071701) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 071701) |
| 207R00000X Internal Medicine (Licence: GA 5056) | |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2019-02-20 |