| NPI | 1457472490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 14142) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT189464) |
| 207Q00000X Family Medicine (Licence: PA MT189464) | |
| 208M00000X Hospitalist (Licence: FL ME107581) | |
| 208M00000X Hospitalist (Licence: NV 14142) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2013-09-09 |