| NPI | 1124066402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 138984) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 16569) |
| 208M00000X Hospitalist (Licence: AL MD.16569) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2019-06-14 |