| NPI | 1295021962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 1295021962) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 53576) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2017-03-16 |