| NPI | 1962536946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: HI MD14305) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: HI 4583) |
| 207R00000X Internal Medicine (Licence: HI MD-14305) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2016-10-13 |