| NPI | 1972127496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 82098) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 11862) |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2023-11-14 |