| NPI | 1063619849 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 71767) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 71767) |
| 208000000X Pediatrics (Licence: AZ 71767) | |
| 208M00000X Hospitalist (Licence: IL 036.127672) | |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2024-04-02 |