| NPI | 1104131820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 47483) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 47483) |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2021-10-06 |