| NPI | 1568412146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: GA 028997) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: GA 028997) |
| 207Q00000X Family Medicine (Licence: MA 058279) | |
| 208M00000X Hospitalist (Licence: GA 028997) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-02-26 |