| NPI | 1265461784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G81437) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA G81437) |
| 208M00000X Hospitalist (Licence: CA G81437) | |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2021-11-08 |