| NPI | 1821331612 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 115044) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME115044) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2022-09-08 |