| NPI | 1871518597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 18365) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MS 18365) |
| 207P00000X Emergency Medicine (Licence: MS 18365) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2016-09-02 |