| NPI | 1932441292 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 102204544) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0102204544) | 
| Enumeration Date | 2013-03-25 | 
| Last Update Date | 2019-05-09 |