| NPI | 1609189240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS12477) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL DO.1240) |
| 208M00000X Hospitalist (Licence: AL DO.1240) | |
| 208M00000X Hospitalist (Licence: FL OS12477) | |
| Enumeration Date | 2010-07-25 |
| Last Update Date | 2015-03-31 |