| NPI | 1164654604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301094496) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A136874) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2019-03-08 |