| NPI | 1700987773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 60414) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 60414) |
| 207R00000X Internal Medicine (Licence: MO 2002009758) | |
| 208M00000X Hospitalist (Licence: MO 2002009758) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-09-25 |