| NPI | 1255592408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A105925) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A105925) |
| 208M00000X Hospitalist (Licence: UT 13260341-1205) | |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2023-05-18 |