| NPI | 1457309452 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AL MD.19279) | 
| Additional Taxonomies | 208M00000X Hospitalist (Licence: AL MD.19279) | 
| 207R00000X Internal Medicine (Licence: AL MD.19279) | |
| 207Q00000X Family Medicine (Licence: AL MD.19279) | |
| Enumeration Date | 2006-05-04 | 
| Last Update Date | 2013-01-10 |