| NPI | 1902130305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A113726) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R70201) |
| 207R00000X Internal Medicine (Licence: NV 14112) | |
| 207R00000X Internal Medicine (Licence: CA A113726) | |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2017-03-10 |