| NPI | 1104066547 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NH 6630) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NH 6630) |
| 207P00000X Emergency Medicine (Licence: NH 6630) | |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2009-02-26 |