| NPI | 1346219763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OS012798) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS 012798) |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2019-05-23 |