| NPI | 1164625182 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2013-01217) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2013-01217) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2017-03-07 |