| NPI | 1770786980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MA 252730) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT190339) |
| 207R00000X Internal Medicine (Licence: WA MD60135851) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2013-02-25 |