| NPI | 1154612604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A115856) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A115856) |
| 207R00000X Internal Medicine (Licence: OR MD169098) | |
| 208M00000X Hospitalist (Licence: OR MD169098) | |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2017-11-27 |