| NPI | 1609868975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MD D74614) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 23671) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2017-07-26 |