| NPI | 1811123920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD154618) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD D0069181) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: OR MD154618) | |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2023-07-25 |