| NPI | 1912066309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA MD.017904) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301052096) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2012-01-05 |