| NPI | 1861477044 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA 20A9726) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR DO21851) |
| Enumeration Date | 2005-12-12 |
| Last Update Date | 2018-04-19 |