| NPI | 1811331184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 75859) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 75859) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2019-12-17 |