| NPI | 1407823859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 060389) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 060389) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2016-10-31 |