NPI | 1265434633 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60092350) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NV 9906) |
208M00000X Hospitalist (Licence: NV 9906) | |
Enumeration Date | 2005-08-15 |
Last Update Date | 2013-11-19 |