| NPI | 1265678569 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 42167) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R70661) |
| 207R00000X Internal Medicine (Licence: AZ 42167) | |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2019-03-27 |