| NPI | 1841643590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 57755) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 57755) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2021-10-21 |