| NPI | 1053630673 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101254210) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101254210) |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2018-11-13 |