| NPI | 1710115969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 4301090476) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301090476) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2015-09-29 |