| NPI | 1104840693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 42149) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301081343) |
| 207R00000X Internal Medicine (Licence: AZ 42149) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2017-06-29 |