| NPI | 1023159308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60261524) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101241021) |
| 208M00000X Hospitalist (Licence: ME 017873) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-10-07 |