| NPI | 1528216033 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A116060) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A116060) |
| 207R00000X Internal Medicine (Licence: FL ME108589) | |
| 208M00000X Hospitalist (Licence: FL ME108589) | |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2011-06-26 |