| NPI | 1124196431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A76134) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A76134) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: CA A76134) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2017-11-22 |