| NPI | 1790055705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A119142) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A119142) |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA A119142) | |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2022-02-04 |