| NPI | 1265419519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA 107795) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 49590) |
| 207R00000X Internal Medicine (Licence: CA 107795) | |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2023-04-30 |