| NPI | 1366735755 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 62120) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 62120) |
| 208D00000X General Practice (Licence: WI 62120) | |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2015-06-19 |