| NPI | 1972573715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MO R3G47) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO R3G47) |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2012-06-13 |