| NPI | 1336120666 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 30628)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 30628)  | 
| Enumeration Date | 2005-11-14 | 
| Last Update Date | 2022-05-02 |