| NPI | 1982157400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 91367) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: RI MD16603) |
| 207R00000X Internal Medicine (Licence: GA 91367) | |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2022-07-13 |