| NPI | 1962542860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 060300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 238119-1) |
| 207R00000X Internal Medicine (Licence: GA 060300) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2010-03-30 |