| NPI | 1508357377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 009325) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 009325) |
| 208D00000X General Practice (Licence: AZ 009325) | |
| Enumeration Date | 2018-05-28 |
| Last Update Date | 2024-04-12 |