| NPI | 1164400511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 16503) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 31028) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2018-11-26 |