| NPI | 1922028513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 35685) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX K7071) |
| 207R00000X Internal Medicine (Licence: AZ 35685) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2017-05-11 |