| NPI | 1699762054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 058109) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 200000916) |
| 208M00000X Hospitalist (Licence: GA 058089) | |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2013-07-31 |