| NPI | 1053316281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: SC 31461) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 24345) |
| 207R00000X Internal Medicine (Licence: SC 31461) | |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2015-03-09 |