| NPI | 1972036200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 83974) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 83974) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2025-04-08 |