| NPI | 1104808856 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 13483) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MS 13483) |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2013-11-09 |