| NPI | 1801317508 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME152010) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0116030512) |
| 207R00000X Internal Medicine (Licence: MO 2020021221) | |
| 208M00000X Hospitalist (Licence: MO 2020021221) | |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2022-02-04 |