| NPI | 1912380171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MS 26104) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN21957) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2018-10-02 |