| NPI | 1255521126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 061778) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 061778) |
| 208M00000X Hospitalist (Licence: NC 2007-01280) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2018-11-05 |