| NPI | 1033325758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD175853) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD175853) |
| 207Q00000X Family Medicine (Licence: NC 201001235) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2020-10-02 |