| NPI | 1881993673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101256221) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101256221) |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2011-03-20 |
| Last Update Date | 2018-05-21 |