| NPI | 1003128885 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 47945) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 47945) |
| 207R00000X Internal Medicine (Licence: AZ 47945) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2021-02-19 |