| NPI | 1891980777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 35451) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 65091) |
| 207R00000X Internal Medicine (Licence: SC 35451) | |
| 208M00000X Hospitalist (Licence: MN 60032) | |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2020-10-06 |