| NPI | 1659667574 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA C161815) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301105895) |
| 207R00000X Internal Medicine (Licence: TX BP10041503) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2020-06-10 |