| NPI | 1902281272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OS023536) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA OS023536) |
| 207R00000X Internal Medicine (Licence: NV DO2704) | |
| 208M00000X Hospitalist (Licence: NV DO2704) | |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2024-09-12 |