| NPI | 1023194040 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 065187) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 065187) |
| 207R00000X Internal Medicine (Licence: NC 2010-00535) | |
| 208M00000X Hospitalist (Licence: NC 2010-00535) | |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2019-10-10 |