| NPI | 1083648000 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT 69851) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 055116) |
| 207R00000X Internal Medicine (Licence: CO 0061399) | |
| 208M00000X Hospitalist (Licence: GA 055116) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2021-01-04 |