| NPI | 1063618312 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 200800232) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2008-00232) | 
| Enumeration Date | 2007-06-25 | 
| Last Update Date | 2020-10-25 |