| NPI | 1053639872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0102204118) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0102204118) |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2015-04-24 |