| NPI | 1386931004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NV 14498) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.055742) |
| 207R00000X Internal Medicine (Licence: NV 14498) | |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2015-01-12 |