| NPI | 1619915691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 36599) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 36599) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2011-07-13 |