| NPI | 1790098762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NC 2010-01304) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: NC 2010-01304) |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2010-09-27 |