| NPI | 1962681510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PR 16884) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 16884) |
| 207R00000X Internal Medicine (Licence: PR 16884) | |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2016-12-29 |