| NPI | 1104898691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0102201321) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 010221321) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: VA 0102201321) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2013-07-09 |