| NPI | 1003967621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA 20A8312) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 20A8312) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2023-08-22 |