| NPI | 1578564142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 9500754) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 9500754) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2012-08-24 |