| NPI | 1215040613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 200701937) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 200701937) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2020-08-04 |