| NPI | 1992965768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A113476) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX m9391) |
| 282N00000X General Acute Care Hospital (Licence: CA a113476) | |
| Enumeration Date | 2008-06-14 |
| Last Update Date | 2020-08-12 |