| NPI | 1700166576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 48694) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 48694) |
| 207R00000X Internal Medicine (Licence: AZ R72911) | |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2019-08-16 |