| NPI | 1114990207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101234711) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 52553) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2019-08-15 |