| NPI | 1164487443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 101501) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 101501) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2021-11-30 |