| NPI | 1396001897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 35965) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: SC 35965) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2018-11-14 |