| NPI | 1982718714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CO 46152) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-056037) |
| 208M00000X Hospitalist (Licence: IL 036-056037) | |
| 207R00000X Internal Medicine (Licence: CO DR.0046152) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2015-09-14 |