| NPI | 1174705164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 43463) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 43463) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2010-06-23 |