| NPI | 1588647796 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL ME101531)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 034732)  | 
| Enumeration Date | 2005-11-22 | 
| Last Update Date | 2018-09-27 |