| NPI | 1073955381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 7277) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL UO3713) |
| 207R00000X Internal Medicine (Licence: AZ 7277) | |
| Enumeration Date | 2013-07-28 |
| Last Update Date | 2019-08-16 |