| NPI | 1033142138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2008-00231) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 20312) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2015-09-14 |