| NPI | 1962864751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IA 45921) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036154528) |
| 208M00000X Hospitalist (Licence: IL 036154528) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2023-06-21 |