| NPI | 1194997338 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: LA 204682) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 204682) |
| 207Q00000X Family Medicine (Licence: SC 37658) | |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2017-03-09 |