| NPI | 1134120777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 40343) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200201566) |
| 208M00000X Hospitalist (Licence: TN 40343) | |
| Enumeration Date | 2005-08-04 |
| Last Update Date | 2012-08-06 |