| NPI | 1922444280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2016-00322) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R73828) |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2016-05-19 |