| NPI | 1982130712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ R76250) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AZ 56486) |
| 208M00000X Hospitalist (Licence: CO DR.0070651) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2024-01-09 |