| NPI | 1871859553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 20A12912) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: CA 20A12912) |
| 208M00000X Hospitalist (Licence: CA 20A12912) | |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2017-12-13 |