| NPI | 1518002427 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: OR MD27527) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO 44060) |
| 207Q00000X Family Medicine (Licence: OR MD27527) | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2017-04-18 |