| NPI | 1457532509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OK 25124) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OK 25124) |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2017-08-23 |