| NPI | 1417900101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 044097) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 044097) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2014-12-31 |