| NPI | 1386809853 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MO 2011004659) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 5101017894) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2021-01-19 |