| NPI | 1598751281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: MS 19534) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA Q20352) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2017-05-10 |