| NPI | 1932457371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO 2016038201) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 054394) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2021-06-11 |