| NPI | 1952833170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A166479) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ZZ 08885758) |
| 207R00000X Internal Medicine (Licence: CA A166479) | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2020-07-29 |