| NPI | 1205924057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: HI MD-10645) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: HI MD-10645) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2007-12-10 |