| NPI | 1518114909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AZ 46756) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ R70183) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2015-09-02 |