| NPI | 1902046899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 81214) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 81214) |
| 207R00000X Internal Medicine (Licence: MI 4301092870) | |
| 207R00000X Internal Medicine (Licence: AL 31115) | |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2020-08-27 |