| NPI | 1891958922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301098174) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 83940) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2019-09-06 |