| NPI | 1083683056 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NV 1162)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NV 1162)  | 
| Enumeration Date | 2006-03-14 | 
| Last Update Date | 2017-11-15 |