| NPI | 1992177711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101264763) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101264763) |
| Enumeration Date | 2015-10-21 |
| Last Update Date | 2022-11-17 |