| NPI | 1245211739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 068666) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301078979) |
| 207R00000X Internal Medicine (Licence: GA 068666) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2017-01-16 |