| NPI | 1003923715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AR E-6590) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E6590) |
| 208D00000X General Practice (Licence: NE 487) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2022-07-21 |