| NPI | 1972525343 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A82730) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A82730) |
| 174400000X Specialist (Licence: CA A82730) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2014-03-06 |