| NPI | 1386050383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 65100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 65100) |
| 207R00000X Internal Medicine (Licence: WY 11044A) | |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2023-10-13 |