| NPI | 1851305569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101247470) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 051867) |
| 207R00000X Internal Medicine (Licence: VA 0101247470) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2023-02-16 |