| NPI | 1558657551 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 5101019451) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5101019451) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2014-12-26 |