| NPI | 1366602294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 8166517-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ZZ 06803522) |
| 208M00000X Hospitalist (Licence: NM MD2016-0117) | |
| 208M00000X Hospitalist (Licence: ID M-11822) | |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2020-09-17 |