| NPI | 1164697546 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GU M-1709) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GU M-1709) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2019-05-15 |