| NPI | 1255371043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 224431) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 12417) |
| 207R00000X Internal Medicine (Licence: HI 11365) | |
| 208M00000X Hospitalist (Licence: NH 12417) | |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2012-01-26 |