| NPI | 1710950134 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MD D075058) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 27672) |
| 207R00000X Internal Medicine (Licence: NC 2004-01191) | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2017-06-16 |