| NPI | 1992017636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A126013) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A126013) |
| 282N00000X General Acute Care Hospital (Licence: CA 07051659) | |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2022-04-01 |