| NPI | 1164810289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 006653) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 006653) |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2015-10-27 |