| NPI | 1417112475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 065038) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 065038) |
| 207Q00000X Family Medicine (Licence: GA 003461) | |
| 207Q00000X Family Medicine (Licence: GA 065038) | |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2019-10-07 |