| NPI | 1821409855 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 89474) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA 334236) |
| 207R00000X Internal Medicine (Licence: KY 50637) | |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2023-05-30 |