| NPI | 1083925721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 006089) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 11015723A) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2021-06-15 |