| NPI | 1659729820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A152337) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A152337) |
| 207R00000X Internal Medicine (Licence: CA A152337) | |
| 282N00000X General Acute Care Hospital | |
| Enumeration Date | 2016-05-29 |
| Last Update Date | 2021-07-22 |