| NPI | 1972794840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR DO28584) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR DO28584) |
| 207R00000X Internal Medicine (Licence: OR LL17065) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2017-12-07 |