| NPI | 1801812995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2013-02499) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A79740) |
| 207R00000X Internal Medicine (Licence: NC 2013-02499) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2021-03-31 |