| NPI | 1780174565 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 64286) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R76888) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2021-08-24 |