| NPI | 1891744231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ 25595) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL ME92707) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2011-07-05 |