| NPI | 1255388534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PR 4872) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 4872) |
| 282N00000X General Acute Care Hospital (Licence: PR 4872) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2008-04-11 |