| NPI | 1053395988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 200196) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA MD.200196) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2013-11-14 |