| NPI | 1689163180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 009008) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV SL1347) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2022-01-03 |