| NPI | 1285625053 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MT 48306)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CO 23985)  | 
| 207R00000X Internal Medicine (Licence: WY 7813A)  | |
| 207RC0200X Internal Medicine, Critical Care Medicine (Licence: WY 7813A)  | |
| Enumeration Date | 2005-11-02 | 
| Last Update Date | 2022-07-21 |