| NPI | 1801176805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 48933) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 249027) |
| 207R00000X Internal Medicine (Licence: WA MD61306614) | |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2022-11-07 |