| NPI | 1255477055 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 33726)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 33726)  | 
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: AZ 33726)  | |
| 208M00000X Hospitalist (Licence: FL ME128767)  | |
| Enumeration Date | 2007-01-29 | 
| Last Update Date | 2016-11-08 |