| NPI | 1265710305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NM MD2014-0084) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10040139) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2014-08-21 |