| NPI | 1609105204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 46391) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 46391) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: AZ 46391) | |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2025-06-03 |