| 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 | 2024-11-05 |