| NPI | 1780695692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 037424) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 037424) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2015-03-09 |