| NPI | 1043659550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA R-9829) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CO DR0061838) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2019-06-11 |