| NPI | 1477887735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 34977) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: DE 34977) |
| Enumeration Date | 2009-09-18 |
| Last Update Date | 2012-05-27 |