| NPI | 1104976653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ID o254) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID O254) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2018-09-20 |