| NPI | 1275640526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 054634) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA GA 054634) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2018-03-17 |