| NPI | 1821014721 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 51028) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036066423) |
| 207R00000X Internal Medicine (Licence: AZ 51028) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2015-11-19 |