| NPI | 1043212764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 9701402) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 9701402) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2020-10-29 |