| NPI | 1477545739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: VT 042.0012850) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-27109) |
| 208M00000X Hospitalist (Licence: MO 2001018683) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2020-06-04 |