| NPI | 1245223197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 36647) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 36647) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2011-01-03 |