| NPI | 1821184540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 053556) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: GA 053556) |
| 207Q00000X Family Medicine (Licence: GA 053556) | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2013-09-13 |