| NPI | 1609889229 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PR 15122)  | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: PR 15122)  | 
| Enumeration Date | 2006-08-14 | 
| Last Update Date | 2008-04-29 |