| NPI | 1962771386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 9045511-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME115017) |
| Enumeration Date | 2011-12-14 |
| Last Update Date | 2021-03-25 |