| NPI | 1558516963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A114137) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A114137) |
| 208D00000X General Practice (Licence: CA A114137) | |
| Enumeration Date | 2008-11-26 |
| Last Update Date | 2013-12-19 |