| NPI | 1063407625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: NC 200400929) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 27261) |
| 208M00000X Hospitalist (Licence: SC 27261) | |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2017-03-17 |