| NPI | 1194718981 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: UT 5997054-1205) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 29448) | 
| 207R00000X Internal Medicine (Licence: UT 5997054-1205) | |
| Enumeration Date | 2005-08-26 | 
| Last Update Date | 2017-05-05 |