| NPI | 1942594106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01081675A) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MD 77792) |
| 282N00000X General Acute Care Hospital (Licence: MD 77792) | |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2022-10-12 |