| NPI | 1992048763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PR 18721) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 18721) |
| 207R00000X Internal Medicine (Licence: PR 28864R) | |
| 207R00000X Internal Medicine (Licence: PR 29343R) | |
| Enumeration Date | 2013-03-30 |
| Last Update Date | 2015-11-17 |