| NPI | 1639151236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WI 36153) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 36153-020) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2017-06-21 |