| NPI | 1841260718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 043432) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CT 043432) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: CT 043432) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2008-10-01 |