| NPI | 1174519698 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 042-0011633) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2005018610) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2016-08-26 |