| NPI | 1124040696 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A78389)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A78389)  | 
| Enumeration Date | 2006-07-24 | 
| Last Update Date | 2022-07-21 |