| NPI | 1164883112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A16187) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA 20A16187) |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2019-08-08 |