| NPI | 1821074261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 050530) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TN 38873) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2015-07-29 |