| NPI | 1114020666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: ID M12905) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID 12905) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2021-08-25 |