| NPI | 1346236478 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD23886) | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD23886) | 
| 208M00000X Hospitalist (Licence: WI 60159-20) | |
| Enumeration Date | 2005-09-23 | 
| Last Update Date | 2024-07-09 |