| NPI | 1649417791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: FL me102945) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME 102945) |
| Enumeration Date | 2009-01-12 |
| Last Update Date | 2017-05-25 |