| NPI | 1568446540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301072145) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101258914) |
| 208M00000X Hospitalist (Licence: TN 52724) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2018-09-27 |