| NPI | 1790097004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A125737) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A125737) |
| 207RN0300X Internal Medicine, Nephrology (Licence: CA A125737) | |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2021-08-02 |