| NPI | 1790212256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA MD.323788) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.323788) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2021-07-08 |