| NPI | 1063414027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA 66186) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 047393) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2021-10-05 |