| NPI | 1902923451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NV 13174) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A108762) |
| 207R00000X Internal Medicine (Licence: NV 13174) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2022-10-07 |