| NPI | 1053440099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 060731) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 127604) |
| 207R00000X Internal Medicine (Licence: GA 060731) | |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2011-11-15 |