| NPI | 1114218633 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 071932) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 071932) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2022-01-07 |