| NPI | 1760643480 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2011012298) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA R8372) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2017-01-16 |