| NPI | 1730128364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C52906) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME77068) |
| 207RA0000X Internal Medicine, Adolescent Medicine (Licence: FL ME77068) | |
| 208M00000X Hospitalist (Licence: CA C52906) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-12-01 |