| NPI | 1871789792 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: VA 0101245150) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA MD.201703) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2010-10-21 |