| NPI | 1568773588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301096929) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MI 4301096929) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2017-07-19 |