| NPI | 1528379435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 49981) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: HI 5894) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2020-04-28 |