| NPI | 1902976871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60877046) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME96496) |
| 207R00000X Internal Medicine (Licence: FL ME96496) | |
| 208M00000X Hospitalist (Licence: ND 15308) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2023-12-28 |