| NPI | 1912193277 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MI 4301099964) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301099964) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2014-04-28 |