| NPI | 1972592608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ID M9500) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: ID M9500) |
| Enumeration Date | 2005-10-15 |
| Last Update Date | 2019-07-11 |