| NPI | 1235246679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 67380) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A85578) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2012-08-13 |