| NPI | 1740264951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 063757) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 063757) |
| 207R00000X Internal Medicine (Licence: MI 4301082889) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2018-11-12 |