| NPI | 1285667816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO 47210) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 47877-020) |
| 207R00000X Internal Medicine (Licence: CO 47210) | |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2010-12-06 |