| NPI | 1619104254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 50684) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IN 01069138A) |
| 207R00000X Internal Medicine (Licence: MO 2012017112) | |
| 207R00000X Internal Medicine (Licence: AZ 50684) | |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2015-10-06 |