| NPI | 1205967585 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 15540) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME 102644) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2012-03-19 |