| NPI | 1104991652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NH FS0376877) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 11326) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2019-06-25 |