| NPI | 1548576648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 69700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036126273) |
| 207R00000X Internal Medicine (Licence: WI 55008) | |
| Enumeration Date | 2010-08-26 |
| Last Update Date | 2016-02-16 |