| NPI | 1770764649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AL MD.29655) |
| Additional Taxonomies | 208D00000X General Practice (Licence: AL MD.29655) |
| 207R00000X Internal Medicine (Licence: AL MD.29655) | |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2010-05-06 |