| NPI | 1427055482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: GA 070583) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NM 88-94) |
| 207R00000X Internal Medicine (Licence: GA 070583) | |
| Enumeration Date | 2005-07-06 |
| Last Update Date | 2017-01-19 |