| NPI | 1386794386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: IA MD-31413) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 26689) |
| 208M00000X Hospitalist (Licence: NE 26689) | |
| 207Q00000X Family Medicine (Licence: IA 31413) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2017-04-10 |