| NPI | 1174636229 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A76308) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A76308) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2013-12-03 |