NPI | 1629259403 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208M00000X Hospitalist (Licence: TN 44251) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MT186999) |
Enumeration Date | 2007-11-20 |
Last Update Date | 2016-06-23 |