| NPI | 1689668337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301048280) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301048280) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2007-07-09 |