| NPI | 1063739258 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AL MD.31500) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL MD.31500) | 
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: AL MD.31500) | |
| Enumeration Date | 2010-04-27 | 
| Last Update Date | 2020-03-10 |