| NPI | 1184608697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: MD D0069946) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101246784) |
| 207R00000X Internal Medicine (Licence: IN 01049154) | |
| 208M00000X Hospitalist (Licence: VA 0101246784) | |
| 208M00000X Hospitalist (Licence: IN 01049154) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2020-01-24 |