| NPI | 1104811694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 43439) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 053656) |
| 207R00000X Internal Medicine (Licence: TN 43439) | |
| 207R00000X Internal Medicine (Licence: VA 0101254459) | |
| 208M00000X Hospitalist (Licence: VA 0101254459) | |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2014-01-08 |