| NPI | 1831204890 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 229974) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MA 229974) | 
| Enumeration Date | 2006-08-20 | 
| Last Update Date | 2019-02-06 |