| NPI | 1790138451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 92575) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA MD-46121) |
| 208M00000X Hospitalist (Licence: GA 92575) | |
| 208M00000X Hospitalist (Licence: IA MD-46121) | |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2023-06-22 |