| NPI | 1548368129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO DR.0066538) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C52418) |
| 207R00000X Internal Medicine (Licence: FL ME87935) | |
| 208M00000X Hospitalist (Licence: NV 14938) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-12-02 |