| NPI | 1144298399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 47096) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 14271) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2011-08-15 |