| NPI | 1871885277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2014-00561) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2014-00561) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2021-04-01 |