| NPI | 1679646616 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A76881) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A76881) |
| 207RH0002X Internal Medicine Hospice and Palliative Medicine (Licence: CA A76881) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2022-08-02 |