| NPI | 1528085263 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: MI SS066528) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301066528) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2015-07-08 |