| NPI | 1730575200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01080580A) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA 340088) |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2015-04-11 |
| Last Update Date | 2024-02-21 |