| NPI | 1316094931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 47491-20) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 47491) |
| 207P00000X Emergency Medicine (Licence: WI 47491-20) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2015-08-19 |