| NPI | 1851686745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VT 032.0102912) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA ot014225) |
| 208M00000X Hospitalist (Licence: VT 032.0102912) | |
| Enumeration Date | 2011-06-18 |
| Last Update Date | 2014-10-29 |