| NPI | 1861749731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MD D75118) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101263558) |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2020-12-16 |