| NPI | 1124194188 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 034601) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 34601) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2017-03-21 |