| NPI | 1376635839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2013-01517) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: VA 0101243502) |
| 208M00000X Hospitalist (Licence: AR E5399) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2016-10-19 |