| NPI | 1003872714 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2011041481) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MO 2011041481) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2013-01-15 |