| NPI | 1164698767 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NE 25245) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NE 25245) |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2009-10-05 |