| NPI | 1659368231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 32483) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NM MD2012-0416) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2015-05-27 |