| NPI | 1346622842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NV 18140) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ID MRM-1498) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2018-09-06 |