| NPI | 1912360017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA 311476) |
| Additional Taxonomies | 208D00000X General Practice (Licence: LA 311476) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: LA 311476) | |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2024-05-28 |