| NPI | 1780605071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 63353) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60901048) |
| 207R00000X Internal Medicine (Licence: KY 40188) | |
| 208M00000X Hospitalist (Licence: AZ 63353) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2024-06-25 |