| NPI | 1669454690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MS 12417) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MS 12417) |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MS 12417) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2010-06-01 |