| NPI | 1528035284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 19091) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: OK 19091) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2018-10-15 |