| NPI | 1730635095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 75681) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125069245) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2022-11-18 |