| NPI | 1548365844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: WI 41443-020) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 41443) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2018-04-23 |