| NPI | 1972572535 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 62891) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: AZ 62891) |
| 208M00000X Hospitalist (Licence: AZ 62891) | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2023-08-21 |