| NPI | 1609045152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301089667) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WA MD60127500) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2010-06-22 |