| NPI | 1255561189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301093862) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 51642) |
| 207U00000X Nuclear Medicine (Licence: SC 51642) | |
| 208M00000X Hospitalist (Licence: SC 51642) | |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2019-09-10 |