| NPI | 1982135752 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MT MED-PHYS-LIC-87947) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MT MED-PHYS-LIC-87947) |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2025-02-04 |