| NPI | 1124251442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NE 26790) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: IA MD-42613) |
| 207R00000X Internal Medicine (Licence: NE 6056) | |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2019-09-09 |