| NPI | 1255575494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA MD.206175) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 30500) |
| 207R00000X Internal Medicine (Licence: LA MD.206175) | |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2017-04-04 |