| NPI | 1649211830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 34211) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 34211) |
| 208M00000X Hospitalist (Licence: CA 52063) | |
| 207R00000X Internal Medicine (Licence: FL ME94109) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2020-10-07 |