| NPI | 1497010748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 252898) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MA 257914) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2017-08-31 |