| NPI | 1508851841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 27625) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AZ 27625) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2020-05-14 |