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 |