| NPI | 1316177157 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301093752) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA 304889) | 
| Enumeration Date | 2009-07-14 | 
| Last Update Date | 2021-04-13 |