| NPI | 1548422181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: LA MD.205184) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: LA MD.205184) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2018-04-06 |