| NPI | 1992791396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 34144) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 34144) |
| 207R00000X Internal Medicine (Licence: CA G75571) | |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2017-01-04 |