| NPI | 1306189287 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NC 2016-01806) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NC 2016-01806) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2016-12-05 |