| NPI | 1568720720 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WA MD61050051) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101257699) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2020-08-31 |