| NPI | 1245341254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VA 0101265459) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 77785) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-10-03 |