| NPI | 1760579684 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA C130599) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA C130599) |
| 207R00000X Internal Medicine (Licence: LA 201463) | |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CA C130599) | |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2019-10-22 |