| NPI | 1780954297 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2013009628) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2013009628) |
| Enumeration Date | 2012-01-01 |
| Last Update Date | 2019-10-29 |