| NPI | 1366717563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA 129102) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA 129102) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2017-02-21 |