| NPI | 1942696471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 79860) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 7965) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2020-01-30 |