| NPI | 1902194152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO 57014) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV DO1878) |
| 207R00000X Internal Medicine (Licence: NV SL0818) | |
| 207R00000X Internal Medicine (Licence: CO 57014) | |
| Enumeration Date | 2011-07-20 |
| Last Update Date | 2018-08-07 |