| NPI | 1477674232 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME119332) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 44249) |
| 207R00000X Internal Medicine (Licence: AZ 37193) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2018-03-17 |