| NPI | 1265522692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2002015292) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2002015292) |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2018-07-06 |