| NPI | 1013926682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 30118) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 30118-20) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2019-06-26 |