| NPI | 1083752307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MD C0003381) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C0003381) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2019-10-21 |