| NPI | 1134316060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ID MC-0150) |
| Additional Taxonomies | 174400000X Specialist |
| 207R00000X Internal Medicine (Licence: TX N0942) | |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2020-08-21 |