| NPI | 1255771218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 4301102504) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301102504) |
| Enumeration Date | 2013-07-04 |
| Last Update Date | 2016-11-16 |