| NPI | 1659305506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 23824) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: KS 0430314) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2013-07-17 |