| NPI | 1992060966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 74876) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 74876) |
| 207R00000X Internal Medicine (Licence: MN 66226) | |
| Enumeration Date | 2012-07-05 |
| Last Update Date | 2024-12-13 |