| NPI | 1245491679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA MD203561) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA MD203561) |
| 282N00000X General Acute Care Hospital (Licence: LA MD203561) | |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2011-10-26 |