| NPI | 1073553244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 11089170-1205) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA A83601) |
| 207R00000X Internal Medicine (Licence: CA A83601) | |
| 208D00000X General Practice (Licence: CA A83601) | |
| 208M00000X Hospitalist (Licence: NV 12247) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2019-03-06 |