| NPI | 1235266891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CO 42111) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ME md23530) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2020-01-03 |