| NPI | 1073757308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ID O-0669) |
| Additional Taxonomies | 208D00000X General Practice (Licence: OR DO153573) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2012-06-26 |