| NPI | 1316911159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2002-00125) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: NC 2002-00125) |
| 208M00000X Hospitalist (Licence: NC 2002-00125) | |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2019-06-24 |