| NPI | 1619966710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL ME86676) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME86676) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2007-07-08 |