| NPI | 1932319613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 064068) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 64068) |
| 207R00000X Internal Medicine (Licence: GA 64068) | |
| 208M00000X Hospitalist (Licence: GA 64068) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2019-03-25 |