| NPI | 1619962180 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine (Licence: WI 47045) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 47045) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2007-07-08 |