| NPI | 1376749259 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NH 16608) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WY 7858A) |
| 207Q00000X Family Medicine (Licence: VA 0116017715) | |
| 207Q00000X Family Medicine (Licence: NH 16608) | |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2017-04-19 |