| NPI | 1649271511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 025540) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA 025540) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: LA 025540) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2015-03-27 |