| NPI | 1578515607 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: AL 28097) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: MO 2001027302) |
| 207P00000X Emergency Medicine (Licence: AL MD28097) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2009-12-14 |