| NPI | 1114311529 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AR E-10988) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AR E-10988) | 
| Enumeration Date | 2015-03-24 | 
| Last Update Date | 2019-12-19 |