| NPI | 1205099553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 237718) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: UT 10385750-1205) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2017-09-14 |