| NPI | 1528096534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA c53819) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C53819) |
| 207R00000X Internal Medicine (Licence: AL 00025512) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2022-02-18 |