| NPI | 1013931013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2009-00300) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 2009-00300) |
| 208M00000X Hospitalist (Licence: MO 112076) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2019-10-31 |