| NPI | 1710147376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 45030) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R70171) |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2023-05-05 |