| NPI | 1619924958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 054501) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD429428) |
| 208M00000X Hospitalist (Licence: TX M2414) | |
| 208M00000X Hospitalist (Licence: VA 0101243449) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2016-02-09 |