| NPI | 1326298779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 284882) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI L1346413) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2018-07-20 |