| NPI | 1942262209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 67330) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO DR.0039644) |
| 174400000X Specialist (Licence: CO 39644) | |
| 208M00000X Hospitalist (Licence: CO DR.0039644) | |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2023-12-13 |