| NPI | 1912260134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101258086) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101258086) |
| 207R00000X Internal Medicine (Licence: MD D0079809) | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2023-08-30 |