| NPI | 1285138453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 63948) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 63948) |
| 207R00000X Internal Medicine (Licence: AZ 63948) | |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2022-07-25 |