| NPI | 1861835670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-12372) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NE 30190) |
| 207P00000X Emergency Medicine (Licence: AZ 56258) | |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2023-01-12 |