| NPI | 1205827425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0102204842) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 3414) |
| 207R00000X Internal Medicine (Licence: VA 0102204842) | |
| 208M00000X Hospitalist (Licence: AZ 3414) | |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2019-12-19 |