| NPI | 1568759454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A136712) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 136712) |
| 207R00000X Internal Medicine (Licence: MO 2011015914) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2024-02-16 |