| NPI | 1609980648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01061288A) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KY 39915) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2009-11-06 |