| NPI | 1194716613 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101236301)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID M-11346)  | 
| 208M00000X Hospitalist (Licence: ID M-11346)  | |
| Enumeration Date | 2005-11-03 | 
| Last Update Date | 2022-09-28 |