| NPI | 1790958452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A116986) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM MD2010-0711) |
| 207R00000X Internal Medicine (Licence: CA A116986) | |
| Enumeration Date | 2008-04-02 |
| Last Update Date | 2022-08-18 |