| NPI | 1962792499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 49398) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 9727248-1205) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2016-04-25 |