| NPI | 1225211238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101243026) |
| Additional Taxonomies | 174400000X Specialist |
| 208M00000X Hospitalist (Licence: VA 0101243026) | |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2019-10-16 |