| NPI | 1114915758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 200500154) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200500154) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2019-07-23 |