| NPI | 1114082567 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2005000623) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2005000623) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2017-05-08 |