| NPI | 1457394801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A55162) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A55162) |
| 208M00000X Hospitalist (Licence: CA A55162) | |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2007-07-09 |