| NPI | 1861923765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 70830) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 70830-20) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2023-09-18 |